Michigan is also reporting outbreaks among the homeless, while one New York eatery’s employee infected at least 4 customers.

We have been following the efforts to contain the outbreak of Hepatitis A in California. Hepatitis A virus attacks the liver, causing yellowing of the skin or eyes, diarrhea, nausea, stomach pain and fatigue. It extreme cases, it can be fatal. The pathogen is often spread through person-to-person contact and consumption of food or water contaminated with fecal matter.

The fears of public health officials that the disease would spread to other states seem to have been realized, as 2 cases linked to the San Diego outbreak have been treated in Colorado.

An outbreak of hepatitis A in Southern California raised concern among Colorado health officials after two homeless people who apparently contracted the disease in San Diego were treated here.

After the cases were reported in late summer, the Colorado Department of Health and Environment began working with homeless shelters and health clinics to vaccinate people and warn them about the danger of contracting the viral disease.

One of the cases was in El Paso County, the other was on the Western Slope, CDPHE spokeswoman Shannon Barbare said Monday.

California health officials believe that an epidemic that has infected more than 500 people statewide since March began in San Diego County, according to a report last week by The Washington Post. Nineteen people there have died from the disease, nearly all of them homeless.

The number of hepatitis A cases reported in Colorado’s general population more than doubled this year. Additionally, Michigan has 14 times more hepatitis A cases than it did last year at this time, and there have been over one dozen deaths in that state as a result of the disease.

The outbreak, which is mainly in southeast Michigan, has sickened 457 people. Of those, 370 have been hospitalized and 18 have died.

The outbreak is complicated. There’s no single source such as food contamination – and many groups of people are at risk, including homeless people, drug users, people who are neither, and now there are more cases among men who have sex with men.

Until October, only 10 men who have sex with men had contracted hep A. Then, in October, there was a sudden spike of 11 additional cases.

The state is urging doctors and hospitals to vaccinate at-risk patients, but officials say resistance is too frequently a problem.

Surprisingly, the homeless and drug users are not the most cooperative of patients. They leave the hospital before the treatment is concluded, and while they are still infectious. These individuals also often refuse to disclose the name of family, friends, and sexual contacts; therefore, public health officials have no way of contacting potentially infectious people for prophylactic treatment.

The San Diego strain is not the one typically found in the United States, said [Dr. Monique Foster, a medical epidemiologist who runs the division of viral hepatitis for the Centers for Disease Control and Prevention], but is a strain called 1B that appears to be spreading here. It is not necessarily more virulent, she said, just hitting hard in an already weakened homeless population.

Many of the 17 hepatitis deaths occurred in people who already had liver disease, said Dr. Eric McDonald, who directs San Diego County’s Epidemiology and Immunization Services Branch. Hospitalizations occurred in many cases because victims were older and already ill or weak.

The virus has been challenging to stem because of its long, 50-day incubation period, meaning someone can be carrying and spreading it for weeks before it’s detected.

Meanwhile, in New York state, a worker at popular eatery infected at least 4 diners, and the local public health department had to round up a couple of thousand customers for free vaccines.

Nearly 1,200 more people, who were potentially exposed to Hepatitis A at Port Chester’s bartaco, were vaccinated on Saturday.

That brings the total number of treated people to about 2,900 since the Westchester County Department of Health began providing free preventive treatments at the County Center on Thursday.

…At least four people in Westchester contracted the disease as early as September, health officials said, and the commonality among them was that they all ate at the popular Port Chester restaurant.

The CDC report you cited doesn’t make any claim about how this outbreak of HVA 1B entered this country.

“HAV is usually spread by direct person-to-person contact through the faecal-oral route, but many foodborne outbreaks have been recorded around the world, often caused by infected food handlers or contaminated water.”

The last major outbreak of that particular genotype of Hep A (type 1B) in the States, back in 2013, was from pomegranate seeds imported from Turkey. I had a friend who was working at the CDC during that outbreak. Most people caught it from an “antioxidants blend” bought from Costco supermarkets.

Nothing to do with “illegal immigrants.” A Trumpian Wall will not protect you.

This genotype is rarely seen in the Americas (including Mexico and South America) but circulates in North Africa and the Middle East.

People from Africa and the Middle East illegally immigrate to the US also. Just because it’s “rare” in the Americas doesn’t exclude this as a vector either. If we want to stop the spread of this and other diseases we need to investigate all possible vectors.

The “Trumpian Wall” reduces many risks even if an illegal alien wasn’t the vector for this one.

The CDC continues to report all recent forms of once eradicated diseases are not related to any immigration. This is a remarkable statement … considering how endemic such diseases are to areas where immigration comes from and how little testing was performed.

As far as I have read this outbreak is related more to the chronically homeless, i.e. mentally ill and drug-addicted people living outdoors, than it is to illegal aliens.

I checked recently. Hep A/B immunizations should be good for twenty years, so the shots I got before going to live in India in 2006 should carry me through for another nine years or so when I visit another third world country, California.

And I thought pushing back the poop and filling my canteen with rice paddy water was okay if I didn’t let a leech get in there. We are truly blessed to live in the USA. It’s a pity that some people don’t understand that.

The Hep A outbreak in Santa Cruz, CA is actually worse than the outbreak in San Diego. So far, in our county of 275K people, 75 cases have been identified. The Santa Cruz police have relocated the street people to a local park and have provided them with porta potties and hand washing facilities. It’s a party out there now with the free needles and great dope.